Mediating cultural differences

Dr Daniela Heil's anthropological expertise
is helping to understand the impact of cultural differences on the health of
indigenous communities.

Dr Daniela Heil
first started working with an Aboriginal community in Central Western NSW in
1997 as part of her PhD-related anthropological fieldwork and since then has developed
lifelong relationships with Indigenous communities and people.

Her strong
connection has given her great insight into why the health system is letting
down Aboriginal people.

"Often
non-Aboriginal policy makers refer to the way health care providers should
behave in terms of 'cultural appropriateness', but this term has been coined
from a non-Indigenous perspective," Dr Heil said.

"Instead
Aboriginal people judge healthcare in terms of 'cultural safety'. They place a
greater emphasis on what they have experienced over time, how they feel and how
their feelings are addressed," she said.

With health statistics showing poor
outcomes for Aboriginal peoples and Torres Strait Islanders, including life
expectancies of up to 15 years below those of non-Indigenous Australians,
Heil's work has illustrated that such cultural differences are major factors in
explaining why mainstream health interventions are not embraced by Aboriginal
peoples in the same ways.

Heil, a researcher from the Faculty of
Education and Arts, has built on her PhD research to address the question of
whether the distinctive characteristics of Indigenous cultures can be
successfully accommodated in health policy and practice, in Indigenous peoples'
terms.

Her work,
which has been published in the British Social Science and Medicine Journal,
titled "Conceptualizing "risk taking" in
Australian Aboriginal health" looks at discrepancies between the Indigenous
and non-Indigenous perspective on health and wellbeing.

"Health
providers need to look at Aboriginal perspectives in terms of what do they want
and why they resist culturally appropriate terminology. They also need to look
at risk management with patients – how health providers talk about risk and
consider from the Aboriginal perspective what it means to do risky things," Dr
Heil said.

Dr Heil says
it's not that Indigenous people don't care about their health; it's just that
they place a greater importance on others so putting their health first can end
up contradicting their cultural values.

"If their
doctors says 'you must take your medication – it's your priority', that order
might contradict ten other social obligations that are their priority in
culturally oriented terms. That is, for Aboriginal Australians greater emphasis
is placed on responsibilities for family, so if they are seen to be putting their
individual selves first, it's about risking and jeopardising the social acceptance
of their kin," Dr Heil said.

The outcomes
of Dr Heil's work contribute to informing health care policy formation with a
greater emphasis on extended family networks and considerations for the
differing local issues in each Indigenous community.

"If someone
gets five minutes of advice on how to be healthy and then goes home and can't
incorporate that into their life, it makes no difference. I'm proposing if you
take the time to explain health care issues in culturally safe ways, even
though it might cost more to do it properly in the long run, it will actuallyhave
a significant affect on Indigenous health outcomes," Dr Heil said.

As an
interesting side project, since 2006 Dr Heil has studied a relatively new
phenomenon where German parents use Ukraine surrogates to give birth to the biological
children of the former.

"Couples fly
to the Ukraine where egg and sperm are implanted into surrogates, who then give
birth nine months later," she said. "As soon as the child is born the parents
go to Germany, get a passport issued, the mother says that she gave birth to
the child in the Ukraine, then they fly home."

"I'm
interested in it in terms of legality. In Germany it's illegal because the
surrogate gave birth – they don't accept that the biological mother has given
birth. The German government is trying to deal with how to accept these
children and it will have consequences later when the children decide to marry
as they do not have a proper birth certificate to this point in time," Dr Heil
said.

Dr Heil's work
in this area will soon be featured in the Cambridge Anthropology journal.

Career Summary

Biography

Research ExpertiseMy research expertise is in social and medical anthropology. I have established a sound reputation in Australian Aboriginal and Torres Strait Islander health and well being research. My research expertise derives from, and works with, the conjunctures and disjunctures of Australian Indigenous practices and mainstream health approaches. The overall aim of my research has been to set up, develop, elaborate and maintain approaches that mediate national Indigenous health policy agendas with the socio-cultural differences of localised Indigenous knowledges, practices and understandings. To date, my anthropological fieldwork and related research have been situated in Australian Indigenous communities in New South Wales, Western Australia and the Torres Straits. Further research interests address gestational surrogacy experiences and practices.

Teaching ExpertiseTeaching: SOCA1020 Introduction to Social and Cultural Anthropology SOCA2325 Cultural Worlds of Health and Illness SOCA3315 Living the Body SOCA3630 Drugs in Culture SOCA4090 Honours I SOCA4100 Honours II SOCA6190 Gender and Social Change

Administrative ExpertiseSociology and Anthropology Honours Convenor (since January 2010) Research Ethics Advisor (REA), Arts and Social Science, Human Research Ethics Committee (HREC), March 2012-June 2014 Acting Deputy Chair (HREC), August 2013-June 2014 Progress and Appeals Committee, School of Humanities and Social Science Representative (since January 2013) Acting Program Convenor, Master of Social Change and Development (Sem 1, 2013; Sem 1, 2014)

Heil D, 'Happiness in an Aboriginal Australian community: What it means 'to be well' and 'to enjoy life' in Central-Western New South Wales, Australia', Happiness Across Cultures: Views of Happiness and Quality of Life in Non-Western Cultures, Springer, Dordrecht 195-208 (2012) [B1]

2009

Heil D, 'Embodied selves and social selves: Aboriginal well-being in rural New South Wales, Australia', Pursuits of Happiness: Well-Being in Anthropological Perspective, Berghahn Books, New York 88-108 (2009) [B1]

Conference (4 outputs)

Year

Citation

Altmetrics

Link

2011

Heil D, 'The Social and the person, not the individual: Traces and legacies of Australian Aboriginal Ngyiampaa understandings of obligations to and responsiveness from 'the social'', Abstracts of the 110th Annual Meeting of the American Anthropological Association, Montreal, Quebec (2011) [E3]

Research Supervision

Current Supervision

Developing a 'Best Practice' in the Development and Delivery of Postmodern and Critical Sexuality Education in AustraliaStudies In Human Society, Faculty of Education and ArtsCo-Supervisor

2014

Exploring the use of Long-Acting Reversible Contraception in a Cohort of Young, Australian WomenPublic Health, Faculty of Health and MedicineCo-Supervisor

2014

Places to Go: Witches to See
Alternative Counter-Cultural Spiritual Practices among Australian YouthStudies In Human Society, Faculty of Education and ArtsPrincipal Supervisor

2014

Women's Stories and What They Tell About Indigenous Health Behaviours: An Exploration Into Stories About Pluralistic Healthcare PracticesStudies In Human Society, Faculty of Education and ArtsPrincipal Supervisor

The Politics and Experience of Contemporary MotherhoodStudies In Human Society, Faculty of Education and ArtsCo-Supervisor

Past Supervision

Year

Research Title / Program / Supervisor Type

2013

A Sociological Investigation of Trust in Complementary and Alternative Medicine UseStudies In Human Society, Faculty of Education and ArtsCo-Supervisor

2012

Obesity is Killing our People: Social Constructions of Obesity and the Impact on the Health and Well-being of Maori and Pacific Island Migrants in AustraliaStudies In Human Society, Faculty of Education and ArtsCo-Supervisor